Dear PGY3 Emergency Medicine Residents,

My name is Dr. Tara Coles and I am an Emergency Residency Graduate from the Class of 2005.  I was also a Chief Resident during my PGY4 year. After completing residency, I was an Academic EM Physician for 3 years before moving to a community ED in Suburban Washington DC.  I am writing to highly encourage you to consider throwing your hat into the Chief Residency ring.

Being elected Chief Resident was one of the most important experiences and greatest honors of my professional life.  It is very unique and special that EM Chief Residents are voted for the position by attendings, residents, and nurses. It is a demonstration of the respect that peers and faculty have for you. You are seen as a role model.  It is a testament to one’s clinical and academic excellence, but even more importantly it is a endorsement of leadership abilities and a testament to your perceived potential as a leader in Emergency Medicine.

You are entering the home stretch of your medical training. In a short period of time you will enter the next chapter of your career. Once again, you will feel like a beginner in many ways and leadership opportunities will take a back seat to getting your sea legs steady and strong. You will be in the rough waters of an ED as the attending, no longer on the solid ground of residency.  Being Chief Resident is a unique opportunity to intensely develop critical leadership skills within a safe haven where you have tremendous support and sponsorship. People want you to do well and succeed. This is a rare occasion where you will rapidly learn invaluable skills in the realms of administration, education, communication, diplomacy, conflict resolution, time management, and work-life balance. And you will learn how to fail quickly and get immediate feedback on how to do better, how to recover from mistakes – I cannot emphasize enough how priceless this is.  

If you take a long-term view of your hard earned career, Chief Residency is your first real chance to step up into a significant and well-regarded leadership role. As an attending, you will be expected and required in the future to serve on committees and boards and advisory panels. Now is not the time to downshift, but to rally your energy and climb the steep learning curve ahead of you.  As Chief Resident you get a seat at the table with your faculty and mentors and a window into the inner machinery that keeps an Emergency Department thriving and responsive. It is a role where you get the chance to use your unique talents to advance not only your own ambitions but what’s even more fulfilling – you get to help your residents grow into their best and most competent selves.

I guarantee that you will learn how to listen in a totally new way, how to stand up for injustice with grace and servility, how to affect change with respect and collaboration, how to be a bridge and a sounding board and a mentor. I recommend going back to your medical school and residency application essays and see if your hopes, dreams, and wishes about your career resonate with the opportunity that Chief Residency offers you.

Now, think about the reasons for holding back. Does it feel like too much time, too much responsibility, too much hassle, too much scheduling work? Do you want to travel and feel like this might be a barrier? Are you reluctant about dealing with conflict or difficult people or thorny situations? If any of these ring true for you, than being Chief Resident may be the perfect time to confront and tackle these leadership skills because you will absolutely need them in your Emergency Medicine career.  I was pregnant for the first five months of my Chief Residency and then had an infant for the last seven months. It is doable and I never regretted having the dual roles of Chief Resident and new parent. My Co-Chief Residents both traveled for several months and the two of us who were left just picked up the slack. It’s teamwork at it’s best and taught me the importance of advance planning, honest communication, fairness, humility, and servant leadership.

There is drudgery associated with every job worth doing. As a parent of four children I know this to be very true. Major parts of Chief Residency feel like hard dull laborious work without much glory.  They say that a sign of a successful leader is when everyone is equally unhappy with your decisions and there were times that this certainly resonated with me.  I am not recommending that you volunteer to be considered for Chief if you think you will feel resentful or withered by the end of the year. If this is not the time for you, if you cannot make the commitment right now, then I know you will be supported in that decision. But don’t be scared off by the work.  If you approach the job with dedication and a humble heart there is so much to be gained.

At the most recent ACEP meeting, a former resident told me that she remembered me as a Chief Resident who always listened, who advocated for the residents, who demonstrated a calm and centered strength, who often voiced what others were thinking in a way that could be heard and acted upon.  She subsequently became a Chief Resident herself.  This was one of the most meaningful compliments that I have ever received and it reminded me why I so valued and appreciated my role as Chief Resident.  You will get the joy of helping and inspiring others while improving the community that has invested so much in you. Is Chief Residency “worth it?” Only you can answer that question for yourself.  I cannot imagine where I would be if I hadn’t grabbed the chance to serve.

Best Wishes,